Provider Demographics
NPI:1588708598
Name:COMPREHENSIVE HOMECARE, INC
Entity type:Organization
Organization Name:COMPREHENSIVE HOMECARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:913-281-5121
Mailing Address - Street 1:107 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66053-4082
Mailing Address - Country:US
Mailing Address - Phone:913-837-5121
Mailing Address - Fax:913-837-5716
Practice Address - Street 1:107 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:KS
Practice Address - Zip Code:66053-4082
Practice Address - Country:US
Practice Address - Phone:913-837-5121
Practice Address - Fax:913-837-5716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-105-037251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
177305Medicare ID - Type UnspecifiedHOME HEALTH